Racialized inequities in birth outcomes and maternal health following childbirth: the role of maternal early-life disadvantage, adolescent contexts, and pre-pregnancy stress
Summary
This study assesses how social contextual stressors over the maternal pre-pregnancy life course contribute to maternal and child health and the unacceptably wide racialized inequities in maternal and infant health in the United States (US). It aims at uncovering whether and how girls' social developmental contexts shape biosocial stress pathways affecting maternal and child health. It uses secondary analysis of newly available data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a novel, US-representative longitudinal cohort with five waves of data collection beginning in adolescent years and including rich social, contextual, health, and reproductive outcome measures. The central hypothesis is that adolescence is a pivotal period for social stressors that affect maternal and perinatal health and contribute to accelerated aging processes. This hypothesis is based on prior analyses by the study team revealing steeper age-related risk foradverse birth outcomes and maternal depressive symptoms among Black, relative to White, mothers in Add Health--particularly when exposed to more severe adolescent social disadvantage. The study's rationale is that analyzing adolescent contexts and life-course linkages will uncover leverage points for future research and interventions on social stress mechanisms underlying maternal and birth inequities. The study team will analyze Add Health cohort data spanning all five collection waves, from ages 12 to 43, and with new epigenetic markers of maternal stress and aging.